Research Publications (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/216
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Item Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa(AOSIS, 2013-07-05) Sokhela, Dudu Gloria; Makhanya, Jabulile Nonhlanhla; Sibiya, Maureen Nokuthula; Nokes, Kathleen M.Background: Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service. Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed. Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources. Conclusion: Effective health communication strategies contribute to positive experiences by health care users and these can be effected by: (1) involvement of health care providers in planning the construction of health facilities to give input about patient flow, infection prevention and control and provision of privacy, (2) effective complaints mechanisms for users to ensure that complaints are followed up and (3)encouraging users to arrive at the facility throughout the day, rather than the present practice where all users arrive at the clinic early in the morning.Item Exploring intersectionality and HIV stigma in persons receiving HIV care in nurse-led public clinics in Durban, South Africa(Elsevier BV, 2023) Sokhela, Dudu Gloria; Orton, Penelope Margaret; Nokes, Kathleen M.; Samuels, William E.Background: Although stigma associated with South African people living with HIV has declined since the 1980s when HIV/AIDS was first identified, it still persists. Stigma is associated with poor health outcomes and avoidance of interactions with healthcare systems. The HIV stigma framework distinguishes three HIV-related self-stigma mechanisms. Aims: The aims of this study were to explore intersectionality between HIV-stigma mechanisms and selected sociodemographic as well as HIV factors, and interrelationships between three HIV-related self-stigma mechanisms. Setting and method: This study was a secondary analysis of data collected from a cross-sectional sample of people receiving HIV-related primary health care at different municipal clinics in Durban, South Africa (N = 100). Results: The average participant was Black African, female, unemployed, with a monthly income below R2 500, most had completed primary school. No sociodemographic or HIV-related factors were significantly related to total or subscale HIV stigma scores. Respondents reported experiencing (enacted) no stigmatization, did not expect to experience (anticipated) much stigmatization from their social interactions with family, community, healthcareworkers, and reported no strong stigmatizing beliefs about themselves (internalized). Conclusion: Intersectionality did not identify any particular socio-demographic or HIV-related factor associated with greater HIV stigma. Participants reported low HIV stigma arising from interactions with healthcare and social service providers or families. Although no socio-demographic or HIV-related factors were significantly associated with HIV stigma mechanisms in this relatively homogeneous sample, being marginalized can nevertheless result from living with other differences compared to societal norms and result in particular vulnerability when living with HIV/AIDS.Item Factors related to functional exercise capacity amongst people with HIV in Durban, South Africa(AOSIS, 2021-04-29) Orton, Penelope Margaret; Sokhela, Dudu Gloria; Nokes, Kathleen M.; Perazzo, Joseph D.; Webel, Allison R.BackgroundPeople with HIV (PWH), who engage in regular physical activity, have improved fitness, muscular strength, body composition, health-related quality of life and mental health symptoms, but PWH have amongst the lowest physical activity levels of those with any chronic health condition. Furthermore, there is scant evidence examining these relationships in PWH in Africa.Aim
To address these critical gaps, this cross-sectional descriptive research study examined the relationships between demographic, HIV-related, anthropometric factors, neighbourhood walkability and physical activity, amongst PWH in Durban, South Africa.Setting
Respondents (N = 100) were receiving primary healthcare in six eThekwini nurse-run municipal clinics.Methods
Self-reported socio-demographic data were collected, and HIV-related medical data were extracted from respondent's medical charts. Height and weight were measured to calculate the body mass index (BMI, kg/m2); neighbourhood walkability was measured on the Neighbourhood Environment scale; and physical activity, specifically functional exercise capacity, was measured by the 6-min walk test (6MWT).Results
On average, respondents were black African, female, approximately 38 years old and unemployed; men were of normal weight whilst women were overweight. Only 65% of the respondents reached the age- and sex-predicted distance during the 6MWT. Correlational analyses did not reveal any significant relationships between the functional exercise capacity and socio-demographic, HIV-related factors or anthropometric measures.Conclusion
South African PWH do not reach their predicated walking distance on the 6MWT. Engaging community agencies to promote walking as both a means of transportation and leisure physical activity may decrease the risks of a sedentary lifestyle and improve progression towards recommended physical activity targets.